Medical device

ABSTRACT

A stone retrieval suction device facilitates the retention and then relocation and/or removal of objects disposed in a patient&#39;s urinary system. The device includes an elongated member for placement in a channel of a flexible ureteroscope. The elongated member defines a suction passageway which extends longitudinally therethrough. The elongated member is flexible enough to bend with the flexible ureteroscope, and it is strong enough to prevent collapse of the suction passageway when suction is provided through the suction passageway by a vacuum source. The elongated member includes a distal portion for contacting and retaining an object when the suction is provided.

TECHNICAL FIELD

[0001] The invention relates generally to medical devices.

BACKGROUND INFORMATION

[0002] Typical stone retrieval devices are used for retrieving objects,such as kidney stones, that are disposed in easily-accessed areas of apatient's urinary tract. Some known stone retrieval devices areconfigured such that a physician must advance the device past theobject, deploy a basket, and then pull the device back toward the objectto capture the object in the basket. In situations where the object isembedded in tissue or located in a lower calyx of a patient's kidney,the device cannot be advanced beyond the object and therefore cannotcapture the object. Stone retrieval devices configured with graspers canbe used to try to retrieve stones embedded in tissue or located in thelower calyx. These devices typically are not very flexible, however, andtherefore frequently are not useful in reaching and capturing suchobjects. Further, grasping stone retrieval devices may not be able toretrieve a certain object due to the size and/or shape of that object.

SUMMARY OF THE INVENTION

[0003] Objects, such as kidney stones and other natural or foreignmaterials, can become trapped in a patient's urinary system. Theseobjects can be disposed in areas of the urinary system which are noteasily accessed by currently available stone retrieval devices. Thepresent invention relates to medical retrieval devices and relatedmethods for accessing and then retaining, relocating, and/or removing anobject disposed in an internal location of a patient's body (such as theurinary system) which is not easily accessed by currently availableretrieval devices.

[0004] In one aspect, the invention involves a medical device. Themedical device includes an elongated member that is configured forplacement in a channel of a flexible ureteroscope. The elongated memberdefines a suction passageway which extends longitudinally therethrough.The elongated member bends with the flexible ureteroscope when placedwithin the channel of the flexible ureteroscope. The suction passagewayresists collapsing when suction is provided through the suctionpassageway by a vacuum source. The elongated member includes a proximalportion for communicating with the vacuum source to provide the suctionthrough the suction passageway and a distal portion for contacting anobject and retaining the object in contact with the distal portion whenthe suction is provided through the suction passageway.

[0005] Embodiments according to this aspect of the invention can includevarious features. For example, the distal portion can include a taperedtip. The distal portion can include a tip which includes a concaveportion for contacting the object and retaining the object in contactwith the concave portion when the suction is provided through thesuction passageway. The distal portion can include a tip which includesa plurality of members extending radially outward from the tip. Theplurality of members prevent tissue proximate to the object from beingdrawn into the suction passageway when suction is provided through thesuction passageway. The distal portion can include a tip which includesa concave portion. The concave portion prevents tissue proximate theobject from being drawn into the suction passageway when the suction isprovided through the suction passageway. The elongated member caninclude a mesh to reinforce the member and thus resist collapse of thesuction passageway when suction is provided. The mesh can extendlongitudinally and circumferentially along the elongated member. Themesh can include stainless steel. The elongated member can include acoil which extends longitudinally and circumferentially along theelongated member. The proximal portion can include a luer connectorand/or a handle for connecting to the vacuum source. The handle caninclude a switch for selectively enabling and disabling the suctionthrough the suction passageway. The proximal portion can be incommunication with a regulator for regulating the suction through thesuction passageway. The elongated member can be made of a material suchas a biocompatible plastic, a biocompatible polyurethane, or abiocompatible rubber, for example. The elongated member can have anoutside diameter of between two and three french. At least some of thedistal portion can be radiopaque.

[0006] In another aspect, the invention involves a method of contactingand moving an object disposed in a patient. The method includesproviding a vacuum source, providing a flexible ureteroscope andintroducing the ureteroscope into a patient, and providing a medicaldevice. The medical device includes an elongated member that isconfigured for placement in a channel of the flexible ureteroscope. Theelongated member defines a suction passageway extending longitudinallytherethrough. The elongated member bends with the ureteroscope when theelongated member is placed within the channel of the flexibleureteroscope. The suction passageway resists collapsing when suction isprovided through the suction passageway by the vacuum source. Theelongated member includes a proximal portion for communicating with thevacuum source to provide the suction through the suction passageway, anda distal portion for contacting an object and retaining the object incontact with the distal portion when the suction is provided through thesuction passageway. The method further includes introducing the medicaldevice into the channel of the flexible ureteroscope, providing suctionthrough the suction passageway and retaining the object in contact withthe distal portion, and moving the retained object from a first locationin the patient to a second location.

[0007] Embodiments according to this aspect of the invention can includevarious features. For example, the method can further include moving theretained object to a second location. Moving the retained object to asecond location can include moving the retained object outside thepatient or to another location inside the patient.

[0008] The foregoing and other objects, aspects, features, andadvantages of the invention will become more apparent from the followingdescription and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

[0009] In the drawings, like reference characters generally refer to thesame parts throughout the different views. Also, the drawings are notnecessarily to scale, emphasis instead generally being placed uponillustrating the principles of the invention.

[0010]FIG. 1A is an illustrative diagram of a stone retrieval suctiondevice, according to one embodiment of the invention.

[0011]FIG. 1B is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 1A, taken along line B-B in FIG. 1A.

[0012]FIG. 2 is an illustrative diagram of a flexible ureteroscopedisposed in a patient and a stone retrieval suction device incommunication with a vacuum source disposed outside of the patient,according to one embodiment of the invention.

[0013]FIG. 3 is an illustrative diagram of the stone retrieval suctiondevice of FIG. 2 partially disposed in a channel of the flexibleureteroscope.

[0014]FIG. 4A is an illustrative diagram of the stone retrieval suctiondevice of FIG. 2 disposed in the channel of the flexible ureteroscopeand extending out of a distal end of the ureteroscope and into thepatient's kidney.

[0015]FIG. 4B is an illustrative diagram of a stone retrieval suctiondevice disposed in the channel of the flexible ureteroscope and also incommunication with a remote vacuum source through an extension tube,according to another embodiment of the invention.

[0016]FIG. 5 is an illustrative cross sectional view of a distal portionof a stone retrieval suction device disposed inside the patient andproximate an object disposed in the patient's kidney, according to oneembodiment of the invention.

[0017]FIG. 6 is an illustrative cross sectional view of the distalportion of the stone retrieval suction device of FIG. 5 contacting andretaining the object disposed in the patient's kidney.

[0018]FIG. 7 is an illustrative cross sectional view of the distalportion of the stone retrieval suction device of FIG. 6 after the objectdisposed in a patient's kidney has been relocated.

[0019]FIG. 8 is an illustrative cross sectional view of the distalportion of the stone retrieval suction device of FIG. 7 after the objectdisposed in a patient's kidney has been released.

[0020]FIG. 9 is an illustrative cross sectional view of the distalportion of the stone retrieval suction device of FIG. 7 removing theobject from the patient's kidney.

[0021]FIG. 10A is an illustrative diagram of a stone retrieval suctiondevice including a mesh, according to another embodiment of theinvention.

[0022]FIG. 10B is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A,according to one embodiment of the invention.

[0023]FIG. 10C is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A,according to another embodiment of the invention.

[0024]FIG. 10D is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A,according to still another embodiment of the invention.

[0025]FIG. 11A is an illustrative diagram of a stone retrieval suctiondevice including a coil, according to one embodiment of the invention.

[0026]FIG. 11B is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A,according to one embodiment of the invention.

[0027]FIG. 11C is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A,according to another embodiment of the invention.

[0028]FIG. 11D is an illustrative cross sectional view of the stoneretrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A,according to still another embodiment of the invention.

[0029]FIG. 12 is an illustrative cross sectional view of a tapered tipcoupled to a distal portion of the stone retrieval suction device,according to one embodiment to the invention.

[0030]FIG. 13A is an illustrative cross sectional view of a tipincluding a concave portion coupled to a distal portion of the stoneretrieval suction device, according to another embodiment to theinvention.

[0031]FIG. 13B is an illustrative cross sectional view of a tipincluding a concave portion coupled to a distal portion of the stoneretrieval suction device, according to yet another embodiment to theinvention.

[0032]FIG. 14 is an illustrative cross sectional view of a tip includinga plurality of arms extending radially outward coupled to a distalportion of the stone retrieval suction device, according to stillanother embodiment to the invention.

[0033]FIG. 15 is an illustrative cross sectional view of a tapered tipcoupled to a distal portion of the stone retrieval suction deviceincluding a mesh disposed on the inner surface of a wall of theelongated member, according to one embodiment to the invention.

[0034]FIG. 16 is an illustrative cross sectional view of a tip includinga concave portion coupled to a distal portion of the stone retrievalsuction device including a mesh disposed in a wall of the elongatedmember, according to another embodiment to the invention.

[0035]FIG. 17 is an illustrative cross sectional view of a tip includinga plurality of arms extending radially outward coupled to a distalportion of the stone retrieval suction device including a mesh disposedon the outer surface of a wall of the elongated member, according tostill another embodiment to the invention.

[0036]FIG. 18 is an illustrative cross sectional view of a tapered tipcoupled to a distal portion of the stone retrieval suction deviceincluding a coil disposed on the inner surface of a wall of theelongated member, according to one embodiment to the invention.

[0037]FIG. 19 is an illustrative cross sectional view of a tip includinga concave portion coupled to a distal portion of the stone retrievalsuction device including a coil disposed in a wall of the elongatedmember, according to another embodiment to the invention.

[0038]FIG. 20 is an illustrative cross sectional view of a tip includinga plurality of arms extending radially outward coupled to a distalportion of the stone retrieval suction device including a coil disposedon the outer surface of a wall of the elongated member, according tostill another embodiment to the invention.

[0039]FIG. 21 is an illustrative diagram of the stone retrieval suctiondevice including a handle disposed in the channel of the flexibleureteroscope and extending out of a distal end of the ureteroscope andinto the patient's kidney.

[0040]FIGS. 22A and 22B are illustrative cross sectional diagrams of ahandle of the stone retrieval suction device, according to oneembodiment of the invention.

[0041]FIGS. 23A and 23B are illustrative cross sectional diagrams of ahandle of the stone retrieval suction device, according to anotherembodiment of the invention.

[0042]FIG. 24A is an illustrative diagram of a handle of the stoneretrieval suction device, according to still another embodiment of theinvention.

[0043]FIGS. 24B and 24C are illustrative cross sectional diagrams of thehandle shown in FIG. 24A.

DESCRIPTION

[0044] Objects, such as kidney stones (calculi) and other natural orforeign materials, can become trapped in a patient's urinary system.These objects can be disposed in areas of the urinary system that areeasily accessed by currently available stone retrieval devices. Theseobjects can also be disposed in areas of the urinary system, such asembedded in tissue or located in a lower calyx of a patient's kidney,for example, which are not easily accessed by currently available stoneretrieval devices. The present invention relates to medical devices andrelated methods for accessing and then retaining, relocating, and/orremoving an object disposed in an internal area of a patient's body(such as the urinary system) which is difficult or impossible to accesswith currently available retrieval devices or methods.

[0045] Referring to FIGS. 1A and 1B, in one embodiment, the stoneretrieval suction device 100 includes an elongated member 102 whichdefines a suction passageway 110 extending longitudinally therethrough.The elongated member 102 is designed to be placed in a channel of aflexible ureteroscope and has an outside diameter of between two andthree french. The elongated member 102 bends with the flexibleureteroscope when placed within the channel of the flexibleureteroscope. The suction passageway 110 resists collapsing when suctionis provided through the suction passageway 110 by a vacuum source. Forexample, the elongated member 102 can be reinforced to resist collapseof the suction passageway 110 when suction is provided through thesuction passageway 110. Materials that can be used for the elongatedmember 102 include, but are not limited to, biocompatible plastic,biocompatible rubber, and biocompatible polyurethane. In one embodiment,the bendable elongated member 102 is formed of Pebax, PTFE, orPolyuethane. The elongated member further includes a proximal portion108. The proximal portion 108 is in communication with the vacuum sourceto provide suction through the suction passageway 110. In oneembodiment, the proximal portion 108 can also include a luer connector104. The luer connector 104 is used to connect the elongated member 102to the vacuum source. The elongated member further includes a distalportion 106 for making contact with an object disposed in a patient,such as a kidney stone. The distal portion 106 retains the object incontact with the distal portion 106 when suction is provided through thesuction passageway 110. In one embodiment, the distal portion 106 canalso include a tapered tip 112 which is used to contact the object. Inother embodiments, the distal portion 106 can include other types oftips which are discussed in further detail below. In some embodiments,the distal portion 106 can also include a radiopaque material whichfacilitates easily locating the elongated member 102 with a fluoroscopewhen the elongated member 102 is disposed within the patient. Theradiopaque material can be painted on, and/or embedded in, the elongatedmember 102. The radiopaque material can also be a band painted on,embedded in, and/or wrapped around the distal portion 106 of theelongated member 102. In some embodiments, the radiopaque material canbe tungsten filled ink, bismuth subcarbonate, or barium sulfate. Inother embodiments, the radiopaque material can be a platinum or tantalummetal band.

[0046] The elongated member 102 can be extruded from any of thematerials previously described using known extrusion techniques. Theluer connector 104 can be made of molded plastic or metal, such asstainless steel. The tapered tip 112 can also be made of molded plasticor metal.

[0047] Referring to FIGS. 2-4A, in operation, a user (e.g. a doctor orother medical personnel) inserts a distal end 216 of a flexibleureteroscope 214 into the patient's urethra 202. The user advances theflexible ureteroscope 214 so that the distal end 216 passes into andthrough the urinary bladder 204, into and through the ureter 206, andinto the kidney 208. The user positions the distal end 216 of theflexible ureteroscope 214 within the patient's kidney 208 bymanipulating positioning knobs 230, 232. The knob 230 moves the distalend 216 vertically and the knob 232 moves the distal end 216horizontally. By manipulating the positioning knobs 230, 232, andviewing the kidney's 208 interior with an eyepiece 224, the user canposition a distal channel opening 228 of the flexible ureteroscope 214proximate an object, such as a kidney stone, that is disposed in thepatient's kidney 208.

[0048] The user then connects the luer connector 104 to a regulator 210which, in turn, is connected to a vacuum source 212. The vacuum source212 provides suction through the suction passageway 110 and theregulator 210 allows the user to vary the suction provided by the vacuumsource 212 by adjusting a suction adjustment dial 222. In thisembodiment, the vacuum source 212 is located near the patient. Inanother embodiment, the vacuum source 212 can be located remotely and isdiscussed in further detail below.

[0049] As previously described, the elongated member 102 includes amaterial that enables the elongated member 102 to bend with the flexibleureteroscope 214. After the user has inserted the flexible ureteroscope214 into the patient, the user then inserts the distal portion 106 ofthe elongated member 102 into a proximal channel opening 226 at aproximal end 218 of the flexible ureteroscope 214. The user thenadvances the distal portion 106 through the channel 502 (shown in FIG.5) of the flexible ureteroscope 214 until the tapered tip 112 extendsout of the distal channel opening 228 at the distal end 216 of theflexible ureteroscope 214.

[0050] Referring to FIG. 4B, in another embodiment, the elongated member102 can be connected to a remotely located vacuum source 212 (such as avacuum source located on a wall). In this embodiment, the elongatedmember 102 communicates with the regulator 210 through an extension tube402. The luer connector 104 of the elongated member 102 is mated to afirst luer connector 406 disposed on a proximal end 408 of the extensiontube 402. A second luer connector 404 disposed on a distal end 410 ofthe extension tube is connected to the regulator 210.

[0051] Referring to FIGS. 4A, 5, and 6, after the elongated member 102is advanced through the channel 502 so that the tapered tip 112 extendsout of the channel 502 through the distal channel opening 218 and isproximate to a kidney stone 504, the user switches on the suction (usingswitch 220). The suction pulls the kidney stone 504 in a direction(indicated by arrow 506) toward the tapered tip 112. Eventually, thekidney stone 504 makes contact with the tapered tip 112 and is held incontact with the tapered tip 112 by the continuous suction through thesuction passageway 110 (shown in FIG. 1B). If the kidney stone 504 isembedded in tissue, the user moves the tapered tip 112 toward theembedded kidney stone 504. After the tapered tip 112 makes contact withthe embedded kidney stone 504, the suction through the suctionpassageway 110 retains the kidney stone 504 in contact with the taperedtip 112. The user can then pull the kidney stone 504 free by retractingthe distal portion 106 of the elongated member 102 into the channel 502.

[0052] This device and method enables the user to capture and retain thekidney stone 504 even when the kidney stone 504 is embedded in tissue orlocated in a portion of the patient's body that is difficult orimpossible to access with typical basket and/or grabber stone retrievaldevices.

[0053] Referring to FIGS. 7-8, after contacting and retaining the kidneystone 504, the user can reposition the distal end 216 of the flexibleureteroscope 214 with the distal portion 106 of the elongated member 102still extending beyond the distal channel opening 218 and retaining thekidney stone 504 in contact with the tapered tip 112. The purpose ofrepositioning the distal end 216 of the flexible ureteroscope 214 is tomove the kidney stone 504 to an area in the kidney that is easilyaccessed by typical stone retrieval baskets or grabbers. After the userrelocates the kidney stone 504, the user can release the kidney stone504 by discontinuing the suction and retracting the distal portion 106of the elongated member 102 through the distal channel opening 218.After the kidney stone 504 is released, the user can use any of avariety of existing stone retrieval devices to capture and remove thekidney stone 504 from the patient's urinary system. If the kidney stone504 is too large to remove, the user can employ any of a variety stonedestruction devices (such as laser or vibration devices, for example) tobreak the kidney stone 504 into smaller pieces. If the kidney stone 504has a diameter smaller than the diameter of the channel 502 of theflexible ureteroscope 214, the user can remove the kidney stone 504 fromthe patient by pulling the kidney stone 504 through the channel 502 ofthe flexible ureteroscope 214.

[0054] Referring to FIGS. 10A-D and 15-17, in another embodiment, thestone retrieval suction device 100 includes a mesh 1002 which extendslongitudinally and circumferentially along the elongated member 102. Themesh 1002 can be made of stainless steel and/or other material(s). Themesh 1002 can be, for example, formed by two or more cords that arewoven together to form the mesh 1002 with each cord having one or more,for example three or more, component strands. Each of the strands couldbe thin wire or metal or a metal alloy, for example. The mesh 1002reinforces the elongated member 102 so that the elongated member 102does not collapse when suction is provided through the suctionpassageway 110 by the vacuum source 212 (FIG. 4A). The cords of the mesh1002 can be either spaced closely together to form a dense mesh orspaced far apart to form a sparse or open mesh. The mesh 1002 can beaffixed to an inner surface 1006 (FIGS. 10C and 15) or an outer surface1004 (FIGS. 10B and 17) of the elongated member 102. The mesh 1002 canalso be embedded between the inner surface 1006 and the outer surface1004 of the elongated member 102 (FIGS. 10D and 16).

[0055] Referring to FIGS. 11A-D and 18-20, in still another embodiment,the stone retrieval suction device 100 includes a coil 1102 whichextends circumferentially and longitudinally along the elongated member102. The coil 1102 can be made of stainless steel and/or othermaterial(s). The coil 1102 can be, for example, formed by a cord withthe cord having one or more, for example three or more, componentstrands. Each of the strands could be thin wire or metal or a metalalloy, for example. The coil 1102 reinforces the elongated member 102 sothat the elongated member 102 does not collapse when suction is providedthrough the suction passageway 110 by a vacuum source. The coil 1102 canbe tightly wound so that the individual coils are spaced closelytogether to form a dense coil or the coil 1102 an be loosely wound sothat the individual coils are spaced far apart to form an open coil. Aswith the mesh 1002, the coil 1102 can be affixed to the inner surface1006 (FIGS. 11C and 18) or the outer surface 1004 (FIGS. 11B and 20) ofthe elongated member 102. The coil 1102 can also be embedded between theinner surface 1006 and the outer surface 1004 of the elongated member102 (FIGS. 11D and 19).

[0056] Referring to FIG. 12, the distal portion 106 of the elongatedmember 102 can include a tapered tip 112. The tapered tip 112 can bemade of molded plastic or metal, for example, although other materialsor combinations of materials are possible. In another embodiment shownin FIG. 13A, the distal portion 106 can include a tip 1302 with aconcave portion 1304. The concave portion 1304 is used to contact anobject disposed in a patient's urinary system and retain the object incontact with the concave portion 1304 when suction is provided throughthe suction passageway 110. In still another embodiment shown in FIG.13B, the distal portion 106 can include a concave portion 1306 with atapered tip 1308 within the concave portion 1306. The concave portion1306 is used to keep surrounding tissue away from the suction in thetapered tip 1308 when the tapered tip 1308 contacts an object. In yetanother embodiment shown in FIG. 14, the distal portion 106 can includea tip 1402 which includes a plurality of members 1404. The plurality ofmembers 1404 extend radially outward from the tip 1402 and preventtissue (proximate to an object being contacted) from being pulled intothe suction passageway 110. The tips 1302, 1402 can also be made ofmolded plastic or metal.

[0057] Referring to FIGS. 21, 22A, and 22B, in another embodiment, thesuction retrieval device 100 can include a handle 2102. The handle 2102includes a suction button 2104 which is used to enable and disable thesuction in the suction passageway 110 by uncrimping and crimping aportion of the elongated member 102 disposed in the handle 2102. Whenthe suction button 2104 is not pressed (default position), the suctionbutton 2104 is positioned such that a rigid member 2108 presses againstthe suction tube 302 thereby crimping the elongated member 102 anddisabling the suction in the suction passageway 110.

[0058] When the suction button 2104 is pressed (in the directionindicated by arrow 2106), the suction button 2104 is positioned suchthat the rigid member 2108 no longer crimps the elongated member 102,thereby enabling suction in the suction passageway 110. As long as thesuction button 2104 is pressed, the suction in the suction passageway110 is enabled. As soon as the suction button 2104 is released, thesuction in the suction passageway 110 is disabled.

[0059] In operation, after inserting the flexible ureteroscope 214 intothe patient's urinary system, the user connects the luer connector 104to the regulator 210 and then guides the elongated member 102 into andthrough the channel of the flexible ureteroscope 214. The user thenturns on the vacuum source 212 with the switch 220 and adjusts thesuction with suction adjustment knob 222 on the regulator 210. The userpositions the elongated member 102 proximate to an object disposed inthe patient's urinary system by the method previously described, andthen presses the suction button 2104 on the handle 2102 to engage thesuction (by uncrimping the portion of elongated member 102 disposed inthe handle 2102). After the object is captured and relocated to a newposition or removed from the patient, the user releases the button 2104to disengage the suction (by crimping the portion of elongated member102 disposed in the handle 2102) thereby releasing the object.

[0060] Referring to FIGS. 23A and 23B, in still another embodiment, thesuction retrieval device 100 can include a handle 2302. The handle 2302includes a suction port 2306 which is used to enable and disable thesuction in the distal portion 106 of the suction passageway 110. Thesuction port 2306 is an opening to the suction passageway 110 and allowsoutside air to be sucked into the suction passageway 110 by the vacuumsource (as indicated by arrows 2304) when left open or uncovered. As aresult, the suction in the distal portion 106 of the suction passageway110 is significantly reduced or disabled entirely. When the suction port2306 is covered, by a user's finger 2308 for example, the suction port2306 is sealed and the suction in the distal portion 106 of the suctionpassageway 110 is restored.

[0061] Referring to FIGS. 24A-C, in yet another embodiment, the suctionretrieval device 100 can include a handle 2402. The handle 2402 includesa rotatable valve 2404 which is used to enable and disable the suctionin the distal portion 106 of the suction passageway 110 by redirectingthe suction from the vacuum source. The valve 2404 includes a handle2412 (for rotating the valve) and two perpendicular suction tubes 2416,2414. When the valve 2404 is rotated to an open position (FIG. 24B), asuction port 2406 is put in communication with the vacuum source via thesuction tubes 2414, 2416. Outside air is pulled through the suction port2406, through the suction tubes 2414, 2416, and into the suctionpassageway 100 by a vacuum source as indicated by arrow 2408. Thesuction in the distal portion 106 of the suction passageway 110 isthereby disabled. When the valve 2404 is rotated to a closed position(FIG. 24C), the suction port 2406 is sealed and the distal portion 106of the suction passageway 110 is put in communication with the vacuumsource via suction tube 2414. The suction in the suction passageway 110is thereby enabled as indicated by arrows 2410.

[0062] Variations, modifications, and other implementations of what isdescribed herein may occur to those of ordinary skill in the art withoutdeparting from the spirit and scope of the invention. Accordingly, theinvention is not to be defined only by the preceding illustrativedescription.

What is claimed is:
 1. A medical device, comprising: an elongated memberfor placement in a channel of a flexible ureteroscope, the elongatedmember defining a suction passageway extending longitudinallytherethrough, the elongated member bending with the flexibleureteroscope when the elongated member is placed within the channel ofthe flexible ureteroscope, the suction passageway resists collapsingwhen suction is provided through the suction passageway by a vacuumsource, the elongated member comprising: a proximal portion forcommunicating with the vacuum source to provide the suction through thesuction passageway; and a distal portion for contacting an object andretaining the object in contact with the distal portion when the suctionis provided through the suction passageway.
 2. The medical device ofclaim 1 wherein the distal portion comprises a tapered tip.
 3. Themedical device of claim 1 wherein the distal portion comprises a tipcomprising a concave portion for contacting the object and retaining theobject in contact with the concave portion when the suction is providedthrough the suction passageway.
 4. The medical device of claim 1 whereinthe distal portion further comprises a tip comprising a plurality ofmembers extending radially outward from the tip to prevent tissueproximate the object from entering the suction passageway when thesuction is provided through the suction passageway.
 5. The medicaldevice of claim 1 wherein the distal portion further comprises a tipcomprising a concave portion to prevent tissue proximate the object fromentering the suction passageway when the suction is provided through thesuction passageway.
 6. The medical device of claim 1 wherein theelongated member further comprises a mesh to reinforce the elongatedmember and resist collapse of the suction passageway when the suction isprovided through the suction passageway.
 7. The medical device of claim6 wherein the mesh extends longitudinally and circumferentially alongthe elongated member.
 8. The medical device of claim 6 wherein the meshcomprises stainless steel.
 9. The medical device of claim 1 wherein theelongated member further comprises a coil extending longitudinally andcircumferentially for reinforcing the elongated member and resistingcollapse of the suction passageway when the suction is provided throughthe suction passageway.
 10. The medical device of claim 1 wherein theproximal portion further comprises a luer connector.
 11. The medicaldevice of claim 1 wherein the proximal portion communicates with aregulator for regulating the suction through the suction passageway. 12.The medical device of claim 1 wherein the elongated member comprises abiocompatible plastic.
 13. The medical device of claim 1 wherein theelongated member comprises a biocompatible polyurethane.
 14. The medicaldevice of claim 1 wherein the elongated member comprises a biocompatiblerubber.
 15. The medical device of claim 1 wherein the elongated memberhas an outside diameter of between two and three french.
 16. The medicaldevice of claim 1 wherein the proximal portion further comprises ahandle.
 17. The medical device of claim 16 wherein the handle comprisesa switch for selectively enabling and disabling the suction through thesuction passageway when the proximal portion is in communication withthe vacuum source.
 18. The medical device of claim 1 wherein the distalportion comprises a radiopaque material.
 19. A method of contacting andmoving an object disposed in a patient, comprising: providing a vacuumsource; providing a flexible ureteroscope and introducing theureteroscope into the patient; providing a medical device comprising: anelongated member for placement in a channel of the flexibleureteroscope, the elongated member defining a suction passagewayextending longitudinally therethrough, the elongated member bending withthe flexible ureteroscope when the elongated member is placed within thechannel of the flexible ureteroscope, the suction passageway resistscollapsing when suction is provided through the suction passageway bythe vacuum source, the elongated member comprising: a proximal portionfor communicating with the vacuum source to provide the suction throughthe suction passageway; and a distal portion for contacting an objectand retaining the object in contact with the distal portion when thesuction is provided through the suction passageway; introducing themedical device into the channel of the flexible ureteroscope;positioning the flexible ureteroscope to allow the distal portion tocontact the object; providing suction through the suction passageway andretaining the object in contact with the distal portion; and moving theretained object from a first location in the patient to a secondlocation.
 20. The method of claim 19 wherein moving the retained objectto the second location comprises moving the retained object outside ofthe patient.
 21. The method of claim 19 wherein moving the retainedobject to the second location comprises moving the retained object toanother location in the patient.